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General NPI Number Information
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NPI Number | 1174209233
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Entity Type | Organization
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Legal Business Name | ALH PRE-ADMIT TESTING CLINIC
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 22454 HWY 72 STE 340
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City | ATHENS
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State | AL
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Zip | 35613
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Country | US
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Telephone | 256-262-2132
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Fax | 256-262-2135
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Provider Business Mailing Address
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Address Line | 22454 HWY 72 STE 340
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City | ATHENS
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State | AL
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Zip | 35613
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Country | US
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Telephone | 256-262-2132
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Fax | 256-262-2135
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Authorized Official
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Title or Position | DIRECTOR OF PHYSICIAN NETWORK
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Name | SEBRINA HOLT
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Credential |
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Telephone | 256-216-9648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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